The client in the emergency department requires sutures for a laceration on the left leg. Which information is most pertinent prior to suturing the wound?
- A. The client tells the nurse she has never had sutures.
- B. The spouse refuses to leave the room during suturing.
- C. The client shares she is scared of needles.
- D. The client reports hives after having dental surgery.
Correct Answer: D
Rationale: Hives post-dental surgery suggest a possible local anesthetic allergy, critical to know before suturing to avoid anaphylaxis.
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An elderly client is on an anticholinergic metered dose inhaler (MDI) for chronic obstructive pulmonary disease. The nurse would suggest a spacer to
- A. enhance the administration of the medication
- B. increase client compliance
- C. improve aerosol delivery in clients who are not able to coordinate the MDI
- D. prevent exacerbation of COPD
Correct Answer: C
Rationale: Spacers improve the medication delivery in clients who are unable to coordinate the movements of administering a dose with an MDI.
A pregnant woman is hospitalized for treatment of pregnancy induced hypertension (PIH) in the third trimester. She is receiving magnesium sulfate intravenously. The nurse understands that this medication is used mainly for what purpose?
- A. Maintain normal blood pressure
- B. Prevent convulsive seizures
- C. Increase the respiratory rate
- D. Increase uterine blood flow
Correct Answer: B
Rationale: Prevent convulsive seizures. Magnesium sulfate is a central nervous system depressant. While it has many systemic effects, it is used in the client with pregnancy induced hypertension (PIH) to prevent seizures.
An elderly adult is scheduled for repair of a fractured femur this morning. The nurse goes in to administer the preoperative medication of Demerol 75 mg and atropine 0.4 mg IM. The client asks the nurse if he should take his eye drops before surgery. What is the best initial response for the nurse to make?
- A. You can take them when you get back from surgery.
- B. I'll give them to you now.
- C. Let me check with your physician.
- D. What kind of eye drops are you taking?
Correct Answer: D
Rationale: Knowing the type of eye drops (e.g., for glaucoma or infection) determines if they are critical pre-surgery, guiding further action.
The female client with Trichomonas vaginalis is prescribed metronidazole (Flagyl), an antibacterial medication. Which statement indicates the client does not understand the discharge teaching?
- A. I will not be able to drink any alcohol while taking this drug.
- B. My boyfriend will need to take this same medication.
- C. I cannot transmit the disease through oral sex.
- D. I must make sure I take all the pills no matter how I feel.
Correct Answer: C
Rationale: Trichomonas can be transmitted via oral sex; this statement shows misunderstanding. Alcohol avoidance, partner treatment, and full course completion are correct.
The client is receiving a loop diuretic for congestive heart failure. Which medication would the nurse expect the client to be receiving while taking this medication?
- A. A potassium supplement.
- B. A cardiac glycoside.
- C. An ACE inhibitor.
- D. A potassium cation.
Correct Answer: A
Rationale: Loop diuretics like furosemide cause potassium loss; supplements prevent hypokalemia, a common need in CHF.
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